The race to tackle an outbreak in Bolton of the virulent new strain of Covid-19 first identified in India began with a flurry of phone calls on Thursday afternoon. The urgency at senior levels was clear to those on the ground, who were told: “If we throw every bit of Pfizer at you that we can find, how many [people] can you jab this weekend?”
In one meeting, Michael Smith, the chief officer of Bolton’s GP federation, told NHS England they could jab 5,000 people in one weekend – eight times the average rate. “Everybody’s faces were a bit like: what? Really?”
By Sunday evening more than 6,200 people had received a jab at a makeshift mass vaccination site in south-west Bolton. Smith, one of those leading Bolton’s vaccine drive, told the Guardian he wanted another 15,000 people to have received a jab by next Sunday. If that target is met, roughly one in 10 of the town’s adult population will have received their first Covid-19 vaccination in just eight days.
Bolton’s approach has not been without controversy. Many of those vaccinated at the weekend were young people, some only 17, and a local councillor was ticked off by the NHS for saying all Boltonians should visit the site “and the team will find a reason to vaccinate you”.
Matt Hancock on Monday said vaccinating all over-18s was not the government’s approach and that it was better to prioritise the most vulnerable. However, officials in hotspot areas are anxious that the B.1.617.2 variant is circulating more widely among teenagers and people in their 20s. One in five of all 2,323 confirmed cases of the B.1.617.2 variant are in Blackburn with Darwen and Bolton, Hancock said. The strain is fuelling Bolton’s rising infection rate, which is 11 times the UK average and the highest in the country.
The government said people younger than 38 would not be eligible for vaccinations unless they met strict criteria set out by the Joint Committee on Vaccination and Immunisation (JCVI). In Bolton, doctors are taking a permissive, pragmatic approach, carrying out on-the-spot assessments of eligibility using JCVI guidance.
In an area that has above average levels of deprivation, multigenerational households and underlying health conditions, more people are eligible than they realise, said Smith. The approach, while sticking to the JCVI rules, is: “We’re looking for reasons to jab you, not for reasons not to jab you.”
Other regions facing outbreaks are following Bolton’s lead. Sakthi Karunanithi, director of public health at Lancashire county council, said on Monday that vaccines were available for all over-18s who have “any underlying health conditions” or live, work or care for someone who does.
In the car park of Bolton’s Essa academy on Monday, a queue of hundreds of people formed. A team of 70 medics had worked at the site over the weekend, including GPs, podiatrists, physiotherapists, dentists and optometrists, as well as volunteers from the Red Cross and St John Ambulance.
“It is a mammoth undertaking and everyone’s exhausted,” said Smith. “But this is about setting the ambition and saying to people: don’t worry that there won’t be a vaccine – come down and if we assess you as eligible, we will get you a vaccine.”